The Management of Renal Injuries Coincident With Penetrating Wounds of the Abdomen

Tynberg, Peter; Hoch, William H.; Persky, Lester; Zollinger, Robert M.

doi:10.1097/00005373-197306000-00003

Cited by 16 publications

(2 citation statements)

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“…Delay in exploration is rarely harmful, and may have been beneficial in the overall management and recovery of a patient with multiple injuries (Morrow and Mendez, 1970;Tynberg et al, 1973). The incidence of associated organ injuries (33 per cent) in this report is lower than in other series (Scott et al, 1966), but when present were treated on their merits.…”

Section: Discussionmentioning

confidence: 53%

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Segmental dearterialization in penetrating renal trauma

Angorn

1977

British Journal of Surgery

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Refractory renal haemorrhage following low velocity penetrating trauma has conventionally been treated by nephrectomy or partial nephrectomy. Anatomical studies have demonstrated that the renal artery branches are end-arteries, each branch supplying a renal segment, with no collateral artery supply between segments. Life-threatening haemorrhage is arterial, and usually issues from a single segmental artery easily demonstrable by renal angiography. Fourteen patients had various segmental arteries ligated to control haemorrhage. Associated visceral injuries were present in 4 patients. Preoperative selective renal arteriography was possible in 13 patients and demonstrated the bleeding site in all cases. Segmental dearterialization produced haemostasis in 12 of the 14 patients. One patient required nephrectomy and one patient ligation of a second segmental artery to control bleeding. All the patients survived the operative procedure. Supine renin levels were normal on the fourteenth postoperative day and no patient developed hypertension during the follow-up period of 9-24 months. Segmental renal dearterialization by open operation is a simple and effective technique of controlling refractory renal haemorrhage with maximum preservation of renal parenchyma.

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Section: Discussionmentioning

confidence: 53%

“…Reported series indicate that exsanguinating or refractory renal haemorrhage has necessitated partial or total nephrectomy in 30 per cent of patients (Tynberg et al, 1973;Lang, 1975). Maximum conservation of renal parenchyma and preservation of normal renal function is mandatory in the treatment of renal injury.…”

Section: Discussionmentioning

confidence: 99%